New Membership Application

New Membership Application
Your details
Name

First NameLast Name
Residential address

Street Address

Street Address Line 2

City/TownState

Post Code
Is your postal address the same as your residential address?
Postal Address

Street Address

Street Address Line 2

City/TownState

Post Code
Email
example@example.com
Mobile number
Other community, business or professional associations you belong to (optional):

Purpose and membership
The purpose of the Association is to serve the community of Leongatha and surrounding districts by providing places and services for the care of aged persons.

Annual membership is $5, payable upon joining and renewable on 1 December each year. Membership runs from 1 December to 30 November.
Payment method
For bank transfers, use “Membership [your surname]” as the reference and attach proof of payment. Bank details:

Account name: Woorayl Lodge Inc

BSB: 633000

Account number: 151975638
Please attach proof of payment

Cancelof

Association Rules
Please read the Association Rules
I, First Name* Last Name* confirm that I have read and understand the Woorayl Lodge Inc Association Rules.

Signature*
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit year

Member conduct
By signing below, I agree to act honestly and ethically; treat others fairly, respectfully and courteously; and not engage in bullying, discrimination, harassment or verbal or physical abuse. I will act consistently with the purposes of Woorayl Lodge Inc.
Signature
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

Confidentiality Agreement
Please click here to complete the Confidentiality Agreement. (Please note, clicking on the link will open a new tab.)
Date completed

DayMonthYear
2 digit day, 2 digit month, 4 digit year

Membership declaration
I am applying to become a member of Woorayl Lodge Inc. I confirm that I support the purposes of the Association, have read its Association Rules and agree to comply with them. I acknowledge the annual membership contribution and renewal arrangements stated above.
Applicant signature
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Privacy: Woorayl Lodge Inc. collects the information on this form to assess and administer membership, maintain its member register and communicate with members. Information is handled in accordance with applicable privacy laws and Woorayl Lodge policies.

Subcommittees
Subcommittees assist the Board with particular areas of work. Expressing interest does not guarantee appointment; membership and any subcommittee appointment are subject to approval.

Please click here to read and acknowledge the Subcommittee Code of Conduct. (Please note, clicking on the link will open a new tab)
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit year

Submission page
Thank you for completing this application. Once you hit submit below, we will be in contact with you in due course with the outcome.
Should be Empty:

Your details